AB1489 CLINICAL COURSES AND PREGNANCY OUTCOMES OF TWELVE CASES COMPLICATED WITH BEHCET’S DISEASE IN OUR INSTITUTION
Authors: H. Shimada, R. Wakiya, S. Nakashima, T. Miyagi, Y. Ushio, K. Sugihara, R. Mino, M. Mizusaki, K. Chujo, T. Kameda, H. Dobashi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The proportion of women with Behcet's disease (BD) has increased in recent years. BD is often diagnosed at or before the time of conception, however, its impact on the clinical courses and pregnancy outcomes is not fully understood. Previous reports showed that patients with BD had a higher rate of complications such as puerperal cerebrovascular disease and gestational diabetes [1], or pregnancy outcomes like miscarriage and fetal growth restrictions [2]. Therefore, it is important to reveal the clinical course and pregnancy outcomes in patients with BD. <h3>Objectives</h3> The purpose of this study was to analyze the BD pregnancy cases experienced at our facility, and to idetermine the impact of disease on the course of pregnancy. <h3>Methods</h3> We used the data of BD patients who had been treated at planning for pregnancy and gave birth from a single center cohort of rheumatic disease pregnancy registry in our institution. The impact of BD disease activity of BD on pregnancy outocomes was examined, including therapeutic agents such as glucocorticoid (GC) and biologics. <h3>Results</h3> There were 12 pregnancies complicated by BD included in this analyis. The age at conception was 32.6 ± 3.6 years old, and the disease duration was 4.4 ± 3.0 years. The mean BD current activity form (BDCAF) was 0.6 ± 0.8 in 4 oral ulcers and 2 genital ulcers in the involved domain just before conception. At conception, six cases received GC, in addition, two case received adalimumab, and one case received colchicine. There were 4 cases of exacerbation of disease activity (increase of BDCAF) during pregnancy, and the active domains during pregnancy were 3 cases of oral ulcer, 2 cases of genital ulcer, and 1 case of rash and arthritis. Two cases of them needed to increase GC dose, and mean GC dose was 5.6 ± 2.1 mg per day. <b>Table</b> showed pregnancy outcomes. All cases were live births and three cases gave birth in cesarean section, two of which were emergency cesarean section due to abnormal heart rate of the infants. Mean gestational weeks was 39.2 ± 1.5 weeks, and mean birth weight was 2724.4 ± 227.1 gram. Five of the patients had had adverse pregnancy outcomes, three of which required neonatal intensive care unit (NICU) management at birth. In the cases which had exacerbation during pregnancy, three forth had these adverse pregnancy outcomes. <h3>Conclusion</h3> In the pregnancies with BD, the disease activity was relatively stable in many cases, however, attention should be paid to the increase in disease activity, including the subsequent pregnancy outcome. It is also necessary to consider whether to continue biologics and colchicine for controlling disease activity. <h3>References</h3> [1]Iskender C, Yasar O, Kaymak O, Yaman ST, Uygur D, Daisman N. Behcet's disease and pregnancy: a retrospective analysis of course of disease and pregnancy outcome. J Obstet Gynaecol Res 2014;40:1598-1602. [2]Chan TM, Chiou MJ, Kuo CF. Adverse pregnancy outcomes in women with Behcet's disease: population-based registry linkage study in Taiwan. Clin Reumatol 2021;40:4135-4142. [3]Barros T, Braga A, Marinho A, Braga J. Behcet's disease and pregnancy: A retrospective case-control study. Yale J Biol Med 2021;94:585-592. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.